| NPI | 1366890857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036165598) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S4390) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 3161) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61537401) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2024-11-14 |